| NPI | 1104432970 |
|---|---|
| Former Legal Business Name | GENETICS COLLECTION |
| Entity Type | Organization |
| Authorized Contact | ANTISKA TUJUNNA HAYNES Owner 318-505-2079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |